A jury trial set to open on today will weigh whether one of America's largest health care corporations should be held accountable for deaths and injuries at a New Orleans hospital marooned by floodwaters after Hurricane Katrina. The class-action suit is expected to highlight desperate e-mail exchanges, not previously made public, between the hospital and its corporate parent. "Are you telling us we are on our own and you cannot help?" Sandra Cordray, a communications manager at Memorial Medical Center, which sheltered some 1,800 people, wrote to officials at the Tenet Healthcare Corporation's Dallas headquarters after begging them for supplies and an airlift. The suit, brought on behalf of people who were at the hospital during the disaster, alleges that insufficiencies in Memorial's backup electrical system and failed plans for patient care and evacuation, among other factors, caused personal injury and death.
Obama administration officials say they were expecting praise from critics of the new healthcare law when they offered to exempt selected employers and labor unions from a requirement to provide at least $750,000 in coverage to each person in their health insurance plans this year. Instead, Republicans have seized on the waivers as just more evidence that the law is fundamentally flawed because, they say, it requires so many exceptions. To date, for example, the administration has relaxed the $750,000 standard for more than 1,000 health plans covering 2.6 million people. The waivers have become a flash point as supporters and opponents try to shape public perceptions of the law, the Affordable Care Act, signed by President Obama last March 23.
California emergency room doctors are fighting to preserve a state fund that compensates them for treating poor, uninsured patients at private hospitals — money that lawmakers want to shift to the federal insurance program in order to help bridge the budget gap. But doctors say the shift would still leave millions uninsured for the next several years, raising questions about who will pick up the tab at already strained emergency rooms. "We can't deny care to anybody. The hospitals that are barely making it through, this is going to make it unsustainable," said Arturo Pelayo, MD, an emergency physician at St. Francis Medical Center in Lynwood, where up to 20% of the nearly 70,000 emergency patients they see each year are covered by the Emergency Medical Services, or "Maddy," fund.
The doctor was angry. Not long after Blue Cross Blue Shield of Massachusetts urged him and other health care providers to keep their costs down, the insurer this month disclosed it had agreed to an $11 million payout for its former chief executive. In a terse voicemail, the physician told Blue Cross: You have a credibility problem. It was the kind of call Andrew Dreyfus expected. Hired as CEO of Blue Cross last fall, Dreyfus has been championing affordability — prodding payers and providers to work together to rein in the price of medical care following years of double-digit insurance premium increases. Then came the uproar over millions of dollars collected by his predecessor, Cleve L. Killingsworth, and headlines about five-figure annual fees paid to board members. Suddenly, the talk about lowering healthcare costs rang hollow. To many, Killingsworth's pay package and the board's fees— which were suspended more than a week ago in an effort to diffuse the public outcry— undercut Dreyfus's call to control healthcare spending. "It's hard to reconcile those two messages,'' he admitted.
An unlikely battlefield in Texas' budget war is a hushed pink-and-blue hospital nursery, where 1- and 2-pound babies bleat like lambs under heating lamps and neonatal nurses use tiny rulers to measure limbs that are no bigger than fingers. State health officials, searching for solutions to Texas' multibillion-dollar budget shortfall, have set their sights on these neonatal intensive care units, or NICUs, which they fear are being overbuilt and overused by hospitals eager to profit from the high-cost care and by doctors who are too quick to offer pregnant mothers elective inductions and Caesarean sections before their babies are full term.
Although nearly 80% of domestic violence victims who report the incidents to police seek healthcare in emergency rooms, as many as 72% are not identified as victims of abuse. Of those who are, very few are offered adequate support. These findings from a new study point to a missed opportunity to intervene and offer help to women who suffer violence at the hands of an intimate partner. Karin V. Rhodes, MD, directs the Division of Emergency Care Policy Research in the department of Emergency Medicine at the University of Pennsylvania School of Medicine. She says "Emergency departments are a safety net for women with health issues of all kinds, but our study shows we're not doing a good enough job of assessing our patients' entire situation."